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My friend was a popular, promising artist - how did he end up on the streets of Portland, addicted and dangerous?

www.theguardian.com My friend was a popular, promising artist - how did he end up on the streets of Portland, addicted and dangerous?

When I first met Evan B Harris he was fizzing with talent and kindness. So I was shocked to hear he had become homeless and out of control. What happened to him is a story playing out in cities across America

My friend was a popular, promising artist - how did he end up on the streets of Portland, addicted and dangerous?

Seems like they are over complicating it...

"Evan’s younger brother had experienced some serious mental health issues and he was awaiting news of a diagnosis."

"his mother was a schizophrenic and a heroin addict who often paid for her drug habit with sex. They were homeless, moving constantly. Often she would head off for days at a time, leaving Evan with friends or relatives, or sometimes on his own, without food. When he was 11, she took her own life"

"Evan’s father began to suffer with mental health issues. By the time the pandemic arrived, he was in full crisis, using drugs and worried enough about Covid that he had locked himself inside his house. For a week, Evan stayed with him, and they shuttled back and forth to hospital as his father experienced mounting phobias and suicidal thoughts, but refused treatment. At the end of that week, his father took his own life."

Dude literally had the deck stacked against him.

"The real problem came when Evan inherited his share of his father’s estate – $170,000. He used some of the money to rent an apartment. “But I had extreme schizophrenia and I just filled it with trash because I was so out of my mind,” he says. “I was seeing faces dripping down the walls, I couldn’t even be in there.”"

And this, kids, is why the "Housing First" model won't work. Mental Health and addiction treatment have to come first THEN housing.

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  • Mental Health and addiction treatment have to come first THEN housing.

    Some people will struggle with mental illness and addiction their entire lives. Would you think it'd be easier to fight those things when you're homeless or when you aren't?

    I'm Finnish. It's hard to even speak to some Americans, because I genuinely can't fathom some people who consider others to "belong on the street", "they deserve it" and one that has even made it some of my dumbo liberalist Finnish acquaintances "homelessness is a choice".

    Ofc housing first works. Because it's not "housing first" in the sense that it purposefully houses people before getting them mental health or addiction help. It's "housing first" as in "having a place so you don't need to sleep on the street is a priority".

    We have "housing first" (we don't call it anything like that lol) in Finland, and if you were homeless and extremely fucked up on a drug binge, you'd obviously go through a ward to handle the most acute effects and get you on a basic functional level, during which they'd probably communicate with social workers who'd get them some sort of housing.

    The system is good but in practice people aren't perfect and both sides make mistakes; some people are too addicted and have problems and hard to be helped, but also sometimes the bureaucracy is fucked or some social workers / doctors suck.

    Still, as long as those people have an apartment to go to, it's more or less fine.

    People are rarely as fucked up as that, even actively schizophrenic people. (Like literally my upstairs neighbour. No joke.) You shouldn't use a psychotic episode to argue that housing being prioritised is a bad thing. That's just a non-sequitur.

    • You put them in permanent medical care to treat their mental health and addiction, THEN, once they're stable, you move them to housing.

      If they are too mentally ill to become stable, you keep them in medical care.

      • You don't understand how long-term psychiatric care works.

        You don't "cure" schizophrenia, buddy. Most patients are mostly stable.

        I know people with mental illness who sometimes stop taking their meds and start fucking about and being manic, and once they get to be too disruptive, someone calls the cops, the cops go check it out (ours don't murder the mentally ill — which is a massive difference between our countries — ours are bastards still, but less murdery ones), and take him to the ER from which people who can't be helped right away because they're psychotic due to drugs go to a closed ward and people who are psychotic for non-substance reasons go another closed ward.

        Usually though, with cases such as I know, it's quite enough for the cops to take the person to the ER where they give a slow-release IM injection of some antipsychotics, and the people won't be as bothersome for a week or two (there definitely are side effects to these meds, context really matters), but they will be able to go home and won't need to be taken into a ward — because outpatient care is a lot cheaper than inpatient care.

    • We have "housing first" (we don't call it anything like that lol) in Finland, and if you were homeless and extremely fucked up on a drug binge, you'd obviously go through a ward to handle the most acute effects and get you on a basic functional level,

      Putting someone in the psych ward against their will is difficult to impossible in a number of US states, due in part to laws passed in wake of the extreme abuses which occurred in the asylums of the 20th century. So far there hasn't been much legislative movement to change this. There are also nowhere near enough psych ward beds nationwide to stabilize the existing number of homeless who are obviously severely mentally ill.

      Should all these things be fixed? Yes.

      The chance of the federal government or any state governments fixing it is absolute zero.

      In fact, the federal government and the vast majority of state governments are making absolutely no attempt whatsoever.

      • Putting someone in the psych ward against their will is difficult to impossible in a number of US states, due in part to laws passed in wake of the extreme abuses which occurred in the asylums of the 20th century.

        You're talking about indefinite holds. I'm talking about a definite hold of 72 hours, which isn't uncommon in the states either, being a de facto medical necessity, seeing how psychotic people exist. It's called an psychiatric emergency hold.

        We're not talking about people taking over someone's whole life and their rights a la Britney or some much worse case. We're talking about taking someone who's having an episode and treating that episode, then letting them back out again. Sometimes that takes longer than a few days, but usually those people understand enough to actually voluntarily stay after the three days they've had to stay. And if not, and they actually refused medical care, one could take them to jail if they were being disruptive. I believe putting people in jail is something you also do in Aaaamericaa?

        (the video isn't related just I imagined saying that with the same accent and incredulity as in the video)

  • Housing First doesn't mean there's no support services. You obviously know that. I will grant that many talk about Housing First as the only solution for everyone, but this isn't looking true from the research.

    Throwing out Housing First because you found an edge case doesn't mean it isn't valuable for many.

    • This is simply the latest case, it's not an edge case.

      https://ciceroinstitute.org/research/housing-first-is-a-failure/

      "We’ve built over 200,000 new PSH units for the homeless, as they’re known, and, since 2013, the federal government has mandated the Housing First strategy nationwide. Yet since that nationwide mandate has gone into effect, we’ve seen street homelessness increase by almost a fourth. While some advocates cite the overall decline in homelessness since the early 2000s, they ignore that the entire decline was the result of moving people from “transitional” government housing, which was counted as homeless, to “permanent” government housing, which was counted as not homeless. In effect, if one ignores this statistical smoke show, homelessness has gone up almost one-to-one with the increase in permanent housing."

      https://www.thepublicdiscourse.com/2023/07/90060/

      "Housing First forbids requiring beneficiaries, as a condition of receiving assistance, to attend drug rehabilitation programs, look for work, or even take their mental health medicines as directed by a doctor. They can accept services that might be—and often are—offered, but they are under no enforceable obligation to do so. If they take drugs, refuse work, or even are charged with crimes, housing is still available to them.

      That’s like putting a bandage on an inflamed wound without also applying medicine to heal the underlying infection. As a result, many of the unhoused receiving Housing First benefits make no effort to turn their lives around, leaving them mired in dysfunction and dependence."

      https://www.usatoday.com/story/opinion/voices/2024/07/17/housing-homeless-crisis-addiction-recovery-job-training/74352790007/

      "In its worst iteration, Housing First is a no-strings-attached approach. Beneficiaries receive housing and don't need to attend job training programs or agree to a sober lifestyle. It's a well-intentioned approach, but it simply isn't working.

      Since 2019, California has spent $24 billion on homelessness programs, even mandating all state-funded programs to adopt the Housing First model. Homeless resource centers aren't allowed to make housing conditional on participation in addiction recovery or job training programs. Yet chronic homelessness in the state keeps climbing.

      In Utah, Housing First has been the de facto approach since 2005. Yet from 2017 to 2022, the number of chronically homeless skyrocketed 328%. "

  • Housing first is a gift to developers and designed to appeal to middle class baby boomer understanding of the economy. But where is the organized lobbying industry group (doctors? Hospitals?) to accept a gift of treatment centers that appeals to the increasingly numerous friends/relatives-of-mentally-ill-people and others who realize this abundance of disorder is a symptom of global changes and not just a ridiculous number of individuals lacking "character"?

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